| NPI | 1336761196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 83223) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: NC 2023-01661) | |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2025-08-21 |